Denied PhilHealth Benefits Due to Employer's Unremitted Contributions
A worker's PhilHealth claim is rejected because the employer failed to remit the employee's contributions, leaving the employee to bear hospital costs
Premiumintermediate7 minutes
The Situation
What They Said
“Your PhilHealth claim was denied — there are no posted contributions for the last twelve months. You will have to pay the full bill yourself.”
Employers are required by law to deduct PhilHealth contributions from employees' wages and remit them to PhilHealth on behalf of the employee. Many employers deduct the contributions but fail to remit them to PhilHealth — resulting in the employee's contributions not being posted to their PhilHealth record. When the employee then needs to use their PhilHealth benefits, their claim is denied because of the employer's failure. Republic Act 7875 (National Health Insurance Act) and RA 11223 (Universal Health Care Act) impose strict obligations on employers to remit contributions. Employers who fail to remit are liable for the full amount of the employee's unpaid benefits, plus penalties.
The Fallacy
Employee Bears the Consequence of Employer's Failure Fallacy
The hospital's billing office presents the denial of the PhilHealth claim as the employee's problem to solve financially, treating the employer's unremitted contributions as though they are the employee's failure of coverage. Under RA 7875, the employer's obligation to remit is mandatory and enforceable. The employee who paid their share of contributions (through payroll deduction) is not responsible for the employer's failure to forward them. The employer — and potentially PhilHealth itself — must account for this gap.
What the Law Says
Your Legal Foundation
Republic Act No. 7875 (National Health Insurance Act), as amended by RA 11223
“All employers are required to register their employees with the Corporation and remit their contributions together with the employer's share. Employer's contributions that are not remitted to the Corporation shall be considered as a trust fund for the benefit of the employees, and shall be liable for interest at the rate of two percent per month from the date the contribution falls due until paid. In addition, those in default shall be assessed penalties per month of delinquency.”
Your employer was required to remit your PhilHealth contributions every month. If they deducted contributions from your salary but failed to remit them, the employer is liable for the full benefit amount you should have received — plus penalties and interest. File a complaint with PhilHealth against your employer.
PhilHealth Circulars — Member Portal and Contribution Verification
Contribution verification and employer liability — How to Verify Contributions and File an Employer Complaint
“PhilHealth members can verify their posted contributions through the PhilHealth member portal (online.philhealth.gov.ph). If contributions are not posted despite deductions from salary, the member may file a complaint against the employer with the PhilHealth regional office. PhilHealth can collect the unremitted amounts from the employer, including penalties.”
Check your pay slips to verify that PhilHealth contributions were deducted. If deductions appear on your pay slips but are not posted on your PhilHealth record, file a complaint against your employer with the PhilHealth regional office. Bring your pay slips as evidence. Meanwhile, apply for the benefit claim — PhilHealth has mechanisms for employees with employer delinquency.
What Scripture Says
God's Word on This
Leviticus 19:13 (NIV)
“Do not defraud or rob your neighbour. Do not hold back the wages of a hired worker overnight.”
An employer who deducts contributions from an employee's wages and pockets them instead of remitting them is committing the modern equivalent of robbing a neighbour: they took the worker's money in their own name but kept it for themselves. The worker worked and paid — through their deducted wages — for the healthcare coverage that is now being denied them through the employer's dishonesty. God's law and Philippine law agree: this is theft, and the employer is liable.
🔒
You Know the Law — But Do You Know What to Say?
Reading your rights is one thing. Using them under pressure — calmly, correctly, in the right words — is what actually protects you. Members get the scripted rebuttal for this exact situation: what to say first, what to say if they push back, the tone to use, and the constitutional provision to cite. Practise out loud with audio until it's automatic.